The latest available report of the Office for National Statistics survey on the business impact of coronavirus, shows that 28% of business were closed temporarily when the survey was carried out in mid-May . Other estimates indicate between a quarter and a half a million business are in financial distress. As we have seen already, some of these are High Street names.
Sudden income termination and massive increase in demand
The common problem is, of course, the sudden cessation of income. So, what about charities – health charities in particular? The picture is at least as bleak. Charities have seen a similar sudden termination of income. For health charities, this has been accompanied by a massive increase in demand for support and information from patients relating to the coronavirus pandemic – and this is mostly in addition to the normal requests for help that they receive on a daily basis.
Coupled with the difficulties of protecting the safety of staff by working from home and in many cases working with reduced staff numbers due to shielding and furloughing, the double hit of increased demand and sudden drop in income means many health charities are facing the real possibility of going bankrupt.
The Institute of Fundraising, which covers charities in all fields and not just health, reports that in the first half of May, charities received 29% less income than they had expected . The small number of very large charities have been able to respond to this by mounting emergency fundraising campaigns, reaching potential donors through television advertising. However, for most, and especially the small charities (including many specialist health charities), such things are not even dreamed of.
David Martin, CEO of MS Trust, wrote in a diary article at the beginning of May that the Trust receives around 80% of its funding from individuals’ fundraising activities (skydives, cake sales etc.) . This stopped almost overnight and the charity does not receive any Government funding.
The Government has made additional funding available, but the £750 million has to cover a huge number of charities, of which health charities account for a small proportion.
52% of charities reduced level of service
Looking ahead, charities surveyed by the Institute of Fundraising were planning for an average fall of 57% on trading income for the year . 52% of charities had already reduced their level of service and another 12% were preparing to do so. We are already seeing this in health charities who have no option but to prioritise the range of activities they carry out. Of course, it is patient support and information, most of which is additional and complimentary to NHS services, that comes above all else.
We are likely to see health charities having to cut back on large-scale, expensive activities. Awareness campaigns, engagement with policymakers and input into NICE processes and NHS liaison are all likely to be under threat. In some cases, charities may have to write off significant prior investment into programmes they can no longer afford to complete or at least moderate their expected outcomes.
Making an effective contribution to NICE and NHS processes has become increasingly demanding for charities. Expectations have risen so that health charities often need to have expertise in, for example, policy, public affairs, health economics and health technology assessment. Either people with such skills must be employed, or they must be contracted in. Faced with a dire funding situation and a huge demand for patient support, these are skills that might have to be deprioritised together with the projects on which they would have worked.
Market access bodies, who might have anticipated a strong case for access to a treatment coming from patient organisations, may have to revise their expectations, not because patient demand has diminished but because the resources with which to make the case no longer exist.
More help needed
As the NHS and bodies such as NICE (The National Institute for Health and Care Excellence), the SMC (Scottish Medicines Consortium) and so on, revise their processes and introduce additions, they must do more than acknowledge the value of contributions made by patients, they must find ways of helping patient organisations to continue making them when they would otherwise be unable to afford to do so.
The support provided to patient organisations by pharmaceutical companies has always been controversial, yet there are many examples of successful outcomes that have benefited patients and the NHS. Whilst it is right to ensure that the highest standards of probity are maintained, the pharmaceutical industry, the third sector and the NHS may all need to reconsider their views on funding grants to patient bodies. The Code of Practice for the Pharmaceutical, administered by the Prescription Medicines Code of Practice Authority provides a robust process that ensures funds can be provided to patient charities by commercial organisations whilst also ensuring the charities’ independence.
Continue in different way
Charities themselves, rather than completely stopping some activities, will need to look at how they can continue the most important elements in a different way on lower budgets, including buying in expertise in a more efficient way (e.g. smaller, more focused contractors).
We may see more partnerships and collaboration between charities, e.g. a campaign on a specific disease run by a small specialist charity with support from a large more general health charity. The key will be ensuring the objectives of each charity overlap.
We hear a lot of rhetoric about a changed world as we come out of lockdown – a new normal. That applies to patient charities and their crucial involvement in developing and changing health policy. Now is the time to change.
O. f. N. Statistics, “The Business Impact of Coronavirus , analysis o ver time, UK: Waves 2 to 5 Panel,” 9 June 2020. [Online]. Available: https://www.ons.gov.uk/businessindustryandtrade/business/businessservices/articles/businessimpactofcoronavirusanalysisovertimeuk/waves2to5panel.
T. I. o. Fundraising, “Round up of coronavirus impact on charities,” 19 June 2020. [Online]. Available: https://www.institute-of-fundraising.org.uk/guidance/coronavirus/round-up-coronavirus-impact-on-charities/. [Accessed 3rd July 2020].
D. Martin, “David’s Diary: The Impact of COVID-19 on Charities,” MS Trust, 05 May 2020. [Online]. Available: https://www.mstrust.org.uk/news/views-and-comments/davids-diary-impact-covid-19-charities. [Accessed 03 July 2020].